国产罗哌卡因用于颈丛神经阻滞临床观察.doc

国产罗哌卡因用于颈丛神经阻滞临床观察【摘要】 目的 比较康博宁、耐乐品及布比卡因分别用于颈丛神经阻滞的临床效果。 方法 选择60 例择期手术的甲状腺囊肿患者,术前随机分为3 组,行颈丛神经阻滞。Ⅰ组: 0.25%布比卡因;Ⅱ组: 0.25%耐乐品;Ⅲ组:0.25%康博宁。观察患者麻醉起效时间、感觉阻滞情况、术中镇痛效果,记录声嘶、呼吸困难等并发症发生率。疼痛评定采用视觉模拟评分(VSA)法,0～2为效果优,3～5为效果良,6～7为效果差,8～10为无效。 结果 三组VAS评分、麻醉起效时间无明显差异( P0.05) ,三组镇痛效果无明显差异( P0.05),三组麻醉并发症发生率无显著性差异( P0.05) 。结论 康博宁和耐乐品用于颈丛神经阻滞与布比卡因无显著差异,可在临床颈丛神经阻滞中推广应用。 【关键词】 康博宁;罗哌卡因;布比卡因;颈丛神经阻滞 Use of domestic-made ropivacaine in cervical plexus nerve block RUAN Luo-yang,XU Xiao-hong,XU Xiao-meng.Department of Anesthesiology,the Central Hospital of Guangdong Province Agriculture Reclamation,Zhanjiang 524002,China 【Abstract】 Objective To compare the clinical effect of Kangboning and Naropin or bupivacaine uses in block anesthesia of cervical plexus.Methods Choose 60 patients of parathyroid cyst to selective operation,divided into three groups randomly,use block anesthesia of cervical plexus. Group I :0.25% bupivacaine; Group II0.25% Naropin; Group III : 0.25% Comparison. Observes the patient of the time come into effect,and the analgesia effect; record the percentage of hoarseness,dyspnea etc.Results The three group of VAS and the time come into effect were not significant (P0.05),Three groups of the analgesia effects were not significant (P0.05). Three groups of the complications were not significant (P 0.05).Conclusion 0.25% Kangboning or Naropin use in block anesthesia of cervical plexus provides a satisfactory effect. 【Key words】 Kangboning; Ropivacaine; Bupivacaine; Block anesthesia of cervical plexus 罗哌卡因是新型长效酰胺类局麻药[1],其毒性较低,低浓度时感觉神经和运动神经阻滞分离明显,现在已经广泛用于手术麻醉、分娩镇痛及术后镇痛等[1]。本研究观察国产罗哌卡因-康博宁和进口罗哌卡因-耐乐品以及布比卡因用于颈丛神经阻滞效果的比较。 1 资料和方法 1.1 一般资料 60例择期手术的甲状腺囊肿患者,ASAⅠ～Ⅱ级,年龄22～56岁,无心血管疾病,随机分成耐乐品组(盐酸罗哌卡因注射液,批号:阿斯利康),康博宁组(盐酸罗哌卡因粉针,批号:广东顺峰药业有限公司)和布比卡因组(盐酸布比卡因注射液,批号:A0411291,山东华鲁制药有限公司),每组各20例。鲁米钠2 mg/kg,阿托品0.01 mg/kg,术前30 min肌肉注射。患者入室后,常规监测ECG、SpO?2、BP、Hr。耐乐品、康博宁和布比卡因使用0.25%浓度,左右两侧各0.3 mg/kg行颈4一点法注入,深浅各一半药量,两侧注药之间间隔5 min。麻醉后常规吸氧2 L/min,10 min后给氟芬合剂1/2量